Clinical efficacy of invisible mandibular advancement appliances in treating adolescent skeletal class II malocclusion and their impact on temporomandibular joint morphology

Abstract

Objective: This study aims to analyze the clinical efficacy of invisible mandibular advancement appliances in treating adolescent skeletal Class II malocclusion and their impact on temporomandibular joint (TMJ) morphology.

Methods: Seventy-two adolescent patients with skeletal Class II malocclusion were divided into a control group treated with straight wire appliances and a study group treated with invisible mandibular advancement appliances. Changes in TMJ-related angles, facial height parameters, such as SNA, SNB, ANB, MP-FH, N-Me, N-ANS, ANS-Me, joint space measurements, condylar dimensions, lip parameters, including ULP, ULEP, LLEP, Z-angle, upper airway parameters, including Ba-PNS, Ad1-PNS, Ad2-PNS, Mc1Mc2, SPP-SPPW, UMPW, PAS, VLPW, and clinical efficacy were compared between the two groups before and after treatment.

Results: After treatment, the study group exhibited significantly higher values in ANB, MP-FH, ANS-Me, joint spaces, condylar mediolateral width, and Z-angle, while showing lower values in N-Me, N-ANS, condylar height, condylar anteroposterior diameter, ULP, ULEP, and LLEP compared to the control group. For upper airway parameters, the study group had higher values in Ad1-PNS, Ad2-PNS, Mc1Mc2, and SPP-SPPW. The study group also demonstrated superior clinical efficacy, achieving a total effective rate of 94.44%.

Conclusion: The invisible mandibular advancement appliance demonstrates significant clinical efficacy in treating adolescent skeletal Class II malocclusion, effectively improving TMJ morphology while simultaneously optimizing facial profile and airway function.

Keywords: Adolescents; Invisible mandibular advancement appliance; Morphology; Skeletal Class II malocclusion; Temporomandibular joint; Upper airway parameters.